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10 <br /> CD <br /> LAND USE PERMIT APPLICATION— Burnett County, WI g b <br /> Applicant Complete All Sections Below This Line 0Ul <br /> a <br /> Permit Types and Fees�Please,check appropriate boxes) C <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 K <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 '�✓p <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> 0 r <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °< <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 c <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 N <br /> NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o <br /> z <br /> 0 <br /> Property Owner's Name: qo , c <br /> v � <br /> Property Owner's Mailing Address: / S Sfi. E. o <br /> City State Zip <br /> Property Site Address: 2{//� ,z— L?1&/-- &J, �21 o y <br /> Contact's Telephone Number: <br /> r w <br /> Contact's Email: M <,S <br /> **If staff has a question about this application,you will be contacted via emai�l'Make sure your email address is N N <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov R. <br /> Legal Description of Property: d 0 <br /> Section#:J Town#:__4_L_N Range#:__L6-_W Town of: S Lr1� C5 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> Tax ID#(1-5 digit number;found on tax statement): r1 00 e <br /> Proposed Use of Structure/Addition: 5-)—U gr y �2, -� <br /> Anticipated Start Date:(''(, �. ✓(Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: ©[A H i G kO Sewer Installer: , _ <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY V, <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o V) <br /> Ip vKr`cr at_� cSEtl��r4C1L5rn <br /> NoT 'ib �E IIsED Fb1Z HV&U*v 4M/1' D0N <br /> Fee Rec: ISO 00 <br /> Check#: <br /> Date of staff site visit:�j�tS'ZS Initials of site visit staff:�} �? <br /> APPROVED BY LAND SERVICES OFFICIAL: 1 DATE: 9 ZZ zo25 n CO r� <br /> < 3 -� <br /> UPON APPROVAL: APPLI T ST POST COPY OF G <br /> 0 0 C T• C <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT v <br /> Page 1 of 5 � <br /> Burnett County, WI Land Use Application—Rev 11/2024 <br />